Sudan war has led to ‘collapse’ in protection for civilians, warns MSF

The war in Sudan has led to a collapse in the protection of civilians, with communities facing indiscriminate violence, killings, torture and sexual violence, according to a report released by Médecins Sans Frontières (MSF). The NGO added that this is taking place amid persistent attacks on health workers and medical facilities.

The report, A war on people — The human cost of conflict and violence in Sudan, describes how both the Sudanese Armed Forces (SAF) and the Rapid Support Forces (RSF) and their supporters are inflicting horrendous violence on people across the country. The war has wrought a catastrophic toll since fighting began in April 2023, with hospitals attacked, markets bombed, and houses razed to the ground.

Estimates for the total number of people wounded or killed during the war vary, but MSF, which works in eight states across Sudan, revealed that in just one of the hospitals supported by the NGO, Al-Nao Hospital in Omdurman, 6,776 patients were treated for injuries caused by violence between 15 August 2023 and 30 April 2024, an average of 26 people per day. Thousands of patients have been treated for conflict-related injuries across the country, most for wounds cause by explosions, gunshots and stabbings.

The report contains shocking reports of sexual and gender-based violence, especially in Darfur. An MSF survey of 135 survivors of sexual violence, treated by the NGO’s medical teams between July and December 2023 in refugee camps in Chad, found 90 per cent were abused by an armed perpetrator. Fifty per cent were abused in their own home and 40 per cent were raped by multiple attackers. These findings are consistent with testimonies from survivors still in Sudan, demonstrating how sexual violence is being perpetrated against women in their homes and along displacement routes, a characteristic feature of the conflict.

Testimonies detailing targeted ethnic violence against people in Darfur is also provided. In Nyala, South Darfur, people described how, in mid-2023, RSF and aligned militias went house to house, looting, beating and killing people, targeting Masalit and other people of non-Arab ethnicities.

“The men were armed with guns and dressed in RSF camouflage… I was stabbed many times and fell to the ground, “one patient in Nyala told MSF. “As they left my house, they looked at me on the ground. I was barely conscious, but could hear them say, ‘He will die, don’t waste your bullets,’ as one of them pressed his foot on me.”

Throughout the war, hospitals have been looted and attacked routinely. In June, the World Health Organisation said that in hard-to-reach areas only 20 to 30 per cent of health facilities remained functional, and even then, were operating only at minimal levels. MSF has documented at least 60 incidents of violence and attacks on its staff, assets and infrastructure.

The MSF-supported Al-Nao Hospital has been shelled on three separate occasions.

Meanwhile, an air strike in May killed two children after the intensive care unit roof collapsed at the MSF-supported Baker Nahar Paediatric Hospital in El-Fasher. The hospital was forced to close.

Despite the health system struggling to meet people’s needs adequately, humanitarian and medical organisations have frequently been blocked from providing support. Although authorities have begun issuing visas for humanitarian staff more readily, attempts to provide essential medical care are still regularly impeded through bureaucratic blockages, such as refusals to issue travel permits to allow the passage of people and essential supplies.

“The violence of the warring parties is compounded by obstructions,” says Vickie Hawkins, MSF General Director. “By blocking, interfering and choking services when people need them most, withholding stamps and signatures can be just as deadly as bullets and bombs in Sudan. We call on all warring parties to facilitate the scale up of humanitarian aid. Above all, to stop this senseless war on people by immediately ceasing attacks on civilians, civilian infrastructure and residential areas.”

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